Worried All the Time: Understanding GAD in Kids and Teens

It is normal for kids and teens to worry about a big math test, making the team, or fitting in with friends. But what happens when that anxiety never seems to turn off?

When a child or teen worries almost constantly about a wide range of topics like school, health, relationships, and/or what might happen in the future, they might be dealing with Generalized Anxiety Disorder (GAD).

If your child is struggling with frequent worry, you are not alone. Understanding the signs of GAD can help you know when extra support may be needed.

The Hallmark of GAD: Mind and Body Symptoms

GAD is more than just feeling stressed. It is a combination of frequent, uncontrollable worry and real physical symptoms.  In kids and teens, that worry can come with symptoms that affect sleep, focus, mood, and energy.

Common physical signs include:

• Muscle tension
• Feeling restless or fidgety
• Getting tired easily
• Trouble falling or staying asleep
• Irritability 
• Difficulty concentrating 

With GAD, these symptoms tend to show up more days than not and stick around for months, rather than passing once a stressful event is over.

The Fear of the Unknown

People with GAD have a hard time sitting with uncertainty. They struggle with not knowing whether something bad is going to happen to themselves or to the people they love. This can show up as a never-ending cycle of "What If" questions. You might hear your child say things like:

• "What if I fail my English test?"
• "What if my friends don't actually like me?"
• "What if someone breaks into our house?"

Over time, these worries can turn into patterns like assuming the worst or acting as though a feared outcome is certain, even though it is only a possibility.

Why Kids Can Get Stuck in Worry

Worry can feel miserable, but it can also start to feel important, urgent, or hard to stop. Some kids and teens believe worry helps them stay prepared, shows they care, or prevents something bad from happening. They may think, “If I worry enough, I will be ready,” or "If I don't worry about it, that means I don't care…and then something bad could happen."  Some kids and teens spend so much energy thinking through possibilities, planning ahead, and trying to prevent problems that worry begins to feel like a responsibility rather than a choice. These beliefs about worry are themselves a useful treatment target. Because there is always another worry to take its place, changing how a child relates to worry tends to help more than trying to resolve each worry on its own.

How GAD Can Show Up in Daily Life

 GAD symptoms don’t look the same for every child or teen, and anxiety does not always show up in obvious ways. In daily life, these patterns often show up as trying to prepare for every possible outcome or avoiding situations that feel too uncertain.

• Perfectionism and overpreparing: A young person may believe, “If I do everything exactly right, nothing bad will happen.” They might spend hours on one homework assignment, repeatedly check their work, ask for reassurance, or prepare far beyond what the situation requires. While this effort is often motivated by a desire to feel confident or safe, it can become exhausting and reinforce the idea that they need to be perfectly prepared in order to cope.
  
  
• Avoidance and procrastination: Anxiety can also lead kids to put things off. A young person may procrastinate on schoolwork, avoid checking a grade or opening an assignment portal, or struggle to make decisions because the possibility of making a mistake feels overwhelming. Sometimes avoidance happens after a period of overthinking or overpreparing, when the task begins to feel too stressful to face. Avoidance may bring temporary relief, but it prevents kids from learning that they can handle the situation, so the anxiety is more likely to return the next time they face it.
  
  
• Physical complaints: Because physical symptoms are part of GAD, anxiety can show up in the body before it shows up as visible worry. A young person may have frequent stomachaches or headaches, ask to stay home, or visit the school nurse, especially before something that feels stressful. Since these complaints are real and physical, it's not always obvious that anxiety is underneath them, and kids themselves often don't make the connection.

It is not uncommon for the same young person to alternate between overpreparing and avoiding. They may overprepare for one challenge and avoid another, or even switch between the two in the same situation. And physical complaints can show up alongside either one. Understanding the function of these behaviors can help parents and caregivers better recognize when and how anxiety may be getting in the way.

What Helps: Skills That Support Real Change

Some helpful strategies include:

• Notice and name the worry thoughts: Help your child put their worry into words.  For example, a child might come out of a test feeling upset and discouraged, then pause and recognize, “I’m having the thought that I failed.” Naming the thought this way helps kids notice that worry is happening, instead of getting swept up in it right away.
  
  
• Unhook from the thought: Kids with GAD often get pulled into worry as though every thought is a fact. Learning to step back and notice a thought, without automatically following it, can help create space. This helps create space between the child and the worry so the thought feels less overpowering. Getting a little distance from unhelpful thoughts rather than treating them as facts, is one way to loosen worry's grip.
  
  
• Look for the urge that comes with the worry: Worry often pushes kids toward behaviors like overchecking, asking for reassurance, procrastinating, or avoiding. Noticing that urge is important, because it creates a chance to choose a different response.
  
  
• Practice facing the fear:  Taking steps to face the fear helps kids gradually approach situations, thoughts, or feelings that trigger anxiety while reducing the behaviors that keep the anxiety going. For a child with GAD, that often means two things: facing situations they've been avoiding, and dropping the behaviors meant to control uncertainty, like overchecking, repeated reassurance-seeking, or rereading a text before sending it. It can also mean practicing sitting with not knowing how something will turn out.The goal is not to force a child into distress. It is to help them build confidence that they can handle uncertainty and discomfort.
  
  
• Track progress over time: Many families find it helpful to notice patterns in when worry shows up, what makes it worse, and which strategies and tools actually help. In treatment, regularly checking progress can help families see what is changing and where more support is needed.

A Quick Note for Parents About Reassurance

When a child is anxious, it is natural to want to comfort them. Many kids with GAD ask repeated questions like, “Are you sure I will be okay?” or “Do you promise nothing bad will happen?” Offering reassurance may help temporarily in the moment, but too much reassurance can strengthen the message that uncertainty is dangerous and must be solved right away.

A more helpful approach is to respond with warmth and validation while encouraging your child to tolerate uncertainty and use their coping skills. For example, instead of repeatedly answering, “Yes, you'll be okay,” a parent might say, “I can see you're feeling really anxious right now. What skills or strategies can you use to help yourself through this?” This allows parents to validate their child's distress without taking on the job of eliminating uncertainty. 

When to Seek Support

If worry is taking over your child’s daily life, support is available. Treatment for GAD may include therapy, caregiver guidance, and, for some kids and teens, medication management as part of a broader care plan. 

Treatment for GAD is skills-based and grounded in evidence-based care. Cognitive behavioral therapy (CBT), which includes exposure, has the strongest evidence for treating anxiety in kids and teens. Many clinicians also draw on Acceptance and Commitment Therapy (ACT), which helps young people relate to anxious thoughts differently and make room for uncertainty. In practice, this means kids and teens learn how to notice worry, step back from anxious thoughts, make room for uncertainty, and practice facing situations they might otherwise avoid. Parents and caregivers also learn strategies for responding with warmth and support while helping their child build confidence, flexibility, and independence.

Many families also benefit from telehealth options, which can make specialized anxiety treatment easier to access. With the right tools and support, kids and teens can learn to handle worry with more confidence and flexibility.